Louis Rudolph

The physiology of the uterus in labor

The progress in obstetrics in recent years has demonstrated that many complications which occur during pregnancy and labor can be reduced to a minimum by proper prenatal supervision. “Uterine inertia” is an outstanding problem which still confronts us. Blair Bell 1 and Cragin 2 have stated that an effort should be made to determine its cause and treatment before the onset of labor. At present it is impossible to prognosticate whether a patient will or will not have “uterine inertia” in her coming labor. Our investigation was undertaken with the hope that certain facts might be discovered and correlated which might have a bearing on, and stimulate the obstetrician to find a solution of this question. We have attacked the problem experimentally in animals, because we believe that a thorough understanding of the mechanism of labor and the factors that control the activity of the uterine musculature in higher mammals will contribute much to an understanding of these phenomena in man. Our studies up to the present have been confined to the dog and rabbit. In this paper we will report the findings on, first, the mechanism of labor in the dog studied under direct vision; second, the effect of stimulation and section of the extrinsic nerves of the uterus in the rabbit and the dog; third, the effect of certain drugs on the uterus in situ by the use of a method which graphically records uterine motility; fourth, the experimental rupture of the uterus in the dog.

The coordination of the uterus in labor

Abstract In this paper two cases of asymmetrical contractions of the uterus in labor are reported. These cases raised the question of the mechanism concerned. A review of the embryology, comparative anatomy, and physiology of the uterus shows that it has a bilateral origin and that the two halves except where fused act more or less independently. On fusion a correlating mechanism becomes manifest. A type of coordinated activity manifested by the postpartum uterus of the dog has been studied. An extrinsic and intrinsic mechanism has been discovered, one resident in the uterine wall and the other in the uterovaginal ganglia, the former being the most important; and it has been found that the dogs uterine motor mechanism in situ manifests the phenomena of refractory period and “summation.” On the basis of a functionally defective coordinating mechanism, the irregularity in the uterine motility, obliquity of the uterus, in the two cases observed, is explained and a basis for the explanation of other types of abnormal motor activity is offered.

Sulfadiazine concentration in the blood and lochia

Abstract 1. 1. The sulfonamide concentration of the lochia paralleled the blood concentration in each instance. 2. 2. The sulfadiazine routine of 60 grains initially and 15 grains every four hours results in extremely variable blood and lochial concentrations. 3. 3. Ambulatory patients do not always reveal an increase in the amount of lochia. 4. 4. The lochial odor of these patients tended to be “sharper” than that of those nonmedicated.